Correlation Analysis Between BMI And Axillary Lymph Node Metastasis In ER-Positive Breast Cancer

Background and purpose:Breast cancer has become the most common female malignant tumor,and among breast cancer patients,ER-positive breast cancer patients account for the highest proportion.The number of obese people has increased year by year,and the problems caused by obesity and its complications have become more and more acute.The degree of axillary lymph node metastasis is the most common mode of metastasis in breast cancer,which has a great impact on the survival of patients.At present,the relationship between ER-positive breast cancer and obesity is not very clear,and the relationship between obesity and axillary lymph node metastasis is also not clear.We still need to explore and discover,and provide help for the prevention and treatment of ER-positive breast cancer.Information and methods:A retrospective collection of 1,080 patients with primary ER-positive breast cancer who visited our department from January 2015 to October 2020,and collected relevant data(age,menopausal status,height and weight,tumor size,lymph node metastasis,TNM Staging,histological grade,PR,KI67).And use statistical methods to analyze the internal connection.Result:1.1 When discussing the relationship between relevant clinical information and BMI in patients with ER-positive breast cancer,we found that patients aged ≥40 years old had a higher BMI index(P<0.001),and postmenopausal patients had a higher BMI index(P<0.001).Higher patients are more likely to have axillary lymph node metastasis(P=0.021).Patients with KI67 expression ≤30% have a higher BMI index(P=0.036),and patients with a higher clinical stage have a higher BMI index(P=0.005).Other indicators such as histological grade and PR gap are not statistically significant.1.2 When discussing the relationship between relevant clinical information of ER-positive breast cancer patients and axillary lymph node metastasis,we found that non-menopausal patients had a higher degree of axillary lymph node metastasis(P<0.001),and the larger the tumor,the higher the degree of axillary lymph node metastasis(P<0.001)Patients with high clinical stage have a higher degree of axillary lymph node metastasis(P<0.001),patients with a higher histological grade have a higher degree of axillary lymph node metastasis(P=0.032),and patients with a high KI67 expression rate have a higher degree of axillary lymph node metastasis(P=0.036),other indicators are not statistically significant.1.3.In the multivariate logistic regression analysis,the analysis results showed that only tumor size and TNM staging can be used as independent influencing factors for axillary lymph node metastasis in ER-positive breast cancer,and no other indicators can independently affect the axillary lymph node metastasis of ER-positive breast cancer.This also reflects from the side that BMI affects the axillary lymph node metastasis of ER-positive breast cancer patients in the presence of other factors,which provides a direction for our next research.2.1 When discussing which factors affect the relationship between BMI and axillary lymph node metastasis in ER-positive breast cancer,we first studied PR,another hormone receptor closely related to ER in breast cancer.We found that PR ≤ 20% in the group There is a correlation between the degree of axillary lymph node metastasis in patients with ER-positive breast cancer and BMI,while there is no correlation between the degree of axillary lymph node metastasis and BMI in patients with ER-positive breast cancer in the PR>20% group.2.2 When exploring the relationship between BMI and axillary lymph node metastasis in ER-positive breast cancer,we subsequently studied other factors and found that in the histological grade Ⅰ-Ⅱ patients with ER-positive breast cancer had axillary lymph node metastasis There is a correlation between the degree and BMI,but there is no correlation between the degree of axillary lymph node metastasis in ER-positive breast cancer patients in group Ⅲ histological grade.Other indicators have no obvious research significance.Conclusion:1.In ER-positive breast cancer,patients with older age,postmenopausal status,axillary lymph node metastasis,and higher KI67 expression rate have higher BMI index.2.Patients with ER-positive breast cancer with a premenopausal state,larger tumors,higher clinical stages,higher histological grades,and higher expression of KI67 have higher axillary lymph node metastasis.3.Only tumor size and TNM staging can be used as independent factors affecting the axillary lymph node metastasis of ER-positive breast cancer,indicating that BMI affects the axillary lymph node metastasis of ER-positive breast cancer patients in the presence of other factors.4.Our study found that when PR is low,there is a correlation between the degree of axillary lymph node metastasis in ER-positive breast cancer patients and BMI,and when PR is high,ER-positive breast cancer There is no correlation between the patient’s axillary lymph node metastasis and BMI.There is a correlation between the degree of axillary lymph node metastasis in patients with ER-positive breast cancer in the histological grade Ⅰ-Ⅱ and BMI,while the degree of axillary lymph node metastasis in patients with ER-positive breast cancer in the histological grade Ⅲ is not related to BMI.